P201 Deep learning and minimally invasive inflammatory activity assessment: development and score correlation of a pan endoscopy convolutional network

Abstract

Abstract Background Capsule endoscopy (CE) is a valuable tool for assessing inflammation in patients with Crohn's disease (CD). The current standard for evaluating inflammation are validated scores like (and clinical laboratory values) like Lewis score (LS), Capsule Endoscopy Crohn's Disease Activity Index (CECDAl) and ELIAKIM. Recent advances in artificial intelligence (Al) have made it possible to automatically select the most relevant frames in capsule endoscopy. In this study, our objective was to develop an automated scoring system using CE images to objectively grade inflammation. Methods Pan-enteric CE videos (PillCam Crohn's) performed in CD patients between 09/2020 and 01/2023 were retrospectively reviewed and LS, CECDAl and ELIAKIM scores calculated. We developed a convolutional neural network based automated score consisting in the percentage of positive frames selected by the algorithm (for small bowel and colon separately). We correlated clinical data and the validated scores with the artificial intelligence generated score (AIS). Results A total of 61 patients were included. The median LS was 225 [0-6006], CECDAI was 6 [0-33], ELIAKIM was 4 [0-38] and SB_AIS was 0.5659 [0-29.45]. We found a strong correlation between SB_AIS and LS, CECDAl and ELIAKIM scores (Pearson's r= 0.751, r= 0.707, r= 0.655, p =0.001). We found a strong correlation between LS and ELIAKIM (r= 0.768, p = 0.001) and very strong correlation between CECDAl and LS (r= 0.854, p = 0.001) and CECDAl and ELIAKIM scores (r= 0.827, p = 0.001). Conclusion Our study showed that the Al-generated score had a strong correlation with validated scores indicating that it could serve as an objective and efficient method for evaluating inflammation in CD patients. As a preliminary study, our findings provide a promising basis for future refining a CE score that can accurately correlate with prognostic factors and aid in the management and treatment of CD patients.